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Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India

BACKGROUND: Excessive time between diagnosis and initiation of tuberculosis (TB) treatment contributes to ongoing TB transmission and should be minimized. In India, Revised National TB Control Programme (RNTCP) focuses on indicator start of treatment within 7 days of diagnosis for patients with sput...

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Autores principales: Paul, Durba, Busireddy, Arundhathi, Nagaraja, Sharath Burugina, Satyanarayana, Srinath, Dewan, Puneet Kumar, Nair, Sreenivas Achutan, Sarkar, Silajit, Ahmed, Quazi Toufique, Sarkar, Shakuntala, Shamrao, Sreenivas Rao Motta, Harries, Anthony David, Oeltmann, John Ethan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392255/
https://www.ncbi.nlm.nih.gov/pubmed/22792161
http://dx.doi.org/10.1371/journal.pone.0039040
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author Paul, Durba
Busireddy, Arundhathi
Nagaraja, Sharath Burugina
Satyanarayana, Srinath
Dewan, Puneet Kumar
Nair, Sreenivas Achutan
Sarkar, Silajit
Ahmed, Quazi Toufique
Sarkar, Shakuntala
Shamrao, Sreenivas Rao Motta
Harries, Anthony David
Oeltmann, John Ethan
author_facet Paul, Durba
Busireddy, Arundhathi
Nagaraja, Sharath Burugina
Satyanarayana, Srinath
Dewan, Puneet Kumar
Nair, Sreenivas Achutan
Sarkar, Silajit
Ahmed, Quazi Toufique
Sarkar, Shakuntala
Shamrao, Sreenivas Rao Motta
Harries, Anthony David
Oeltmann, John Ethan
author_sort Paul, Durba
collection PubMed
description BACKGROUND: Excessive time between diagnosis and initiation of tuberculosis (TB) treatment contributes to ongoing TB transmission and should be minimized. In India, Revised National TB Control Programme (RNTCP) focuses on indicator start of treatment within 7 days of diagnosis for patients with sputum smear-positive PTB for monitoring DOTS implementation. OBJECTIVES: To determine length of time between diagnosis and initiation of treatment and factors associated with delays of more than 7 days in smear-positive pulmonary TB. METHODS: Using existing programme records such as the TB Register, treatment cards, and the laboratory register, we conducted a retrospective cohort study of all patients with smear-positive pulmonary TB registered from July-September 2010 in two districts in India. A random sample of patients with pulmonary TB who experienced treatment delay of more than 7 days was interviewed using structured questionnaire. RESULTS: 2027 of 3411 patients registered with pulmonary TB were smear-positive. 711(35%) patients had >7 days between diagnosis and treatment and 262(13%) had delays >15 days. Mean duration between TB diagnosis and treatment initiation was 8 days (range = 0–128 days). Odds of treatment delay >7 days was 1.8 times more likely among those who had been previously treated (95% confidence interval [CI] 1.5–2.3) and 1.6 (95% CI 1.3–1.8) times more likely among those diagnosed in health facilities without microscopy centers. The main factors associated with a delay >7 days were: patient reluctance to start a re-treatment regimen, patients seeking second opinions, delay in transportation of drugs to the DOT centers and delay in initial home visits. To conclude, treatment delay >7 days was associated with a number of factors that included history of previous treatment and absence of TB diagnostic services in the local health facility. Decentralized diagnostic facilities and improved referral procedures may reduce such treatment delays.
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spelling pubmed-33922552012-07-12 Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India Paul, Durba Busireddy, Arundhathi Nagaraja, Sharath Burugina Satyanarayana, Srinath Dewan, Puneet Kumar Nair, Sreenivas Achutan Sarkar, Silajit Ahmed, Quazi Toufique Sarkar, Shakuntala Shamrao, Sreenivas Rao Motta Harries, Anthony David Oeltmann, John Ethan PLoS One Research Article BACKGROUND: Excessive time between diagnosis and initiation of tuberculosis (TB) treatment contributes to ongoing TB transmission and should be minimized. In India, Revised National TB Control Programme (RNTCP) focuses on indicator start of treatment within 7 days of diagnosis for patients with sputum smear-positive PTB for monitoring DOTS implementation. OBJECTIVES: To determine length of time between diagnosis and initiation of treatment and factors associated with delays of more than 7 days in smear-positive pulmonary TB. METHODS: Using existing programme records such as the TB Register, treatment cards, and the laboratory register, we conducted a retrospective cohort study of all patients with smear-positive pulmonary TB registered from July-September 2010 in two districts in India. A random sample of patients with pulmonary TB who experienced treatment delay of more than 7 days was interviewed using structured questionnaire. RESULTS: 2027 of 3411 patients registered with pulmonary TB were smear-positive. 711(35%) patients had >7 days between diagnosis and treatment and 262(13%) had delays >15 days. Mean duration between TB diagnosis and treatment initiation was 8 days (range = 0–128 days). Odds of treatment delay >7 days was 1.8 times more likely among those who had been previously treated (95% confidence interval [CI] 1.5–2.3) and 1.6 (95% CI 1.3–1.8) times more likely among those diagnosed in health facilities without microscopy centers. The main factors associated with a delay >7 days were: patient reluctance to start a re-treatment regimen, patients seeking second opinions, delay in transportation of drugs to the DOT centers and delay in initial home visits. To conclude, treatment delay >7 days was associated with a number of factors that included history of previous treatment and absence of TB diagnostic services in the local health facility. Decentralized diagnostic facilities and improved referral procedures may reduce such treatment delays. Public Library of Science 2012-07-09 /pmc/articles/PMC3392255/ /pubmed/22792161 http://dx.doi.org/10.1371/journal.pone.0039040 Text en Paul et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Paul, Durba
Busireddy, Arundhathi
Nagaraja, Sharath Burugina
Satyanarayana, Srinath
Dewan, Puneet Kumar
Nair, Sreenivas Achutan
Sarkar, Silajit
Ahmed, Quazi Toufique
Sarkar, Shakuntala
Shamrao, Sreenivas Rao Motta
Harries, Anthony David
Oeltmann, John Ethan
Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India
title Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India
title_full Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India
title_fullStr Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India
title_full_unstemmed Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India
title_short Factors Associated with Delays in Treatment Initiation after Tuberculosis Diagnosis in Two Districts of India
title_sort factors associated with delays in treatment initiation after tuberculosis diagnosis in two districts of india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392255/
https://www.ncbi.nlm.nih.gov/pubmed/22792161
http://dx.doi.org/10.1371/journal.pone.0039040
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